Application Form
Desired Financing Amount $
Financing will be used for
Working Capital
Debt Restructure
Business Acquistion/Partner Buyout
Revenue Based Working Capital
Other
Contact Information
Name
Title
First Name
Last Name
SSN
Date of Birth
E-mail
example@example.com
Phone
Format: (000) 000-0000.
Are you the sole Owner of the Business
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Information
Business Name
Years in Business
0-1 Year
1-2 Years
3-4 Years
5+ Years
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Monthly rent/mortgage
EIN
Business Start Date
-
Month
-
Day
Year
Date
Current MCA Positions
Yes
No
More than 3 Positions
Annual Revenue
Please Select
Startup
Under $100,000
$100,000-$199,000
$200,000 - $499,000
$500,000 - $999,000
Over $1,000,000
Approximate Credit Score
Please Select
Under 600
600-640
640-660
660-700
700+
Please Describe the Use of Proceeds
Consent
Signature
The Company and the undersigned principal owner of the Company identified above (“Applicant”) represents, acknowledges, and agrees that (1) all information and documents provided to ARF Holdings LLC (“Provider”) are true, accurate, and complete, (2) Applicant will immediately notify Provider of any change in Applicant's financial condition, (3) Provider is authorized to submit this Application and all supporting documents provided by Applicant to its’ affiliates, representatives, successors, assigns, designees, agents, partners, and third-party financial institutions for the purpose of considering commercial financing offers to Applicant (collectively "Recipients"), (4) such Recipients are authorized to request and receive any investigative reports, consumer credit reports, statements from creditors or financial institutions, verifications of information, or any other information that Recipients deem necessary in considering this Application, (5) the undersigned represents that they are authorized to sign this form on behalf of the Company, and (6) THE COMPANY AND PRINCIPAL CONSENT TO RECEIVE CALLS, TEXTS, AND EMAILS FROM PROVIDER AND RECIPIENTS BASED UPON THE CONTACT INFORMATION OF APPLICANT PROVIDED IN THIS APPLICATION.
YES
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